Individual provider Active NPI

Mikeala Marmelo, FNP

  • Family Nurse Practitioner
  • Jacksonville, NC
National Provider Identifier
1306547443
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5017830 Issued in NC
Practice address
51 Office Park Dr
Jacksonville, NC 28546-7327
Phone
(910) 577-5199
NPI assigned
Mar 15, 2023
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5017830 NC Primary

Addresses

Primary practice location

51 Office Park Dr
Jacksonville, NC 28546-7327

Mailing address

350 Coston Rd Lot 3
Richlands, NC 28574-7447
Phone (319) 283-0122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5017830NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Pediatric Associates, P.a. PastSince Mar 19, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1306547443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 COSTON RD LOT 3",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285747447",
            "telephone_number": "319-283-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467327",
            "telephone_number": "910-577-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMELO",
        "first_name": "MIKEALA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.